Role of Pentoxifylline and/or IgM-Enriched Intravenous Immunoglobulin in the Management of Neonatal Sepsis

Akdag, Arzu; Dilmen, Uğur; Haque, Khalide; Díllí, Dílek; Erdeve, Ömer; Goekmen, Tuelin

doi:10.1055/s-0033-1363771

Cited by 43 publications

(66 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…TNF-α and platelet activating factor are the most important among proinflammatory cytokines that have been implicated in the development of NEC. Recently, Akdag et al 21 have shown that 2 patients in the PTX group developed NEC compared with 2 patients in the placebo group, and statistical analysis was not applicable because of the small number of cases. In contrast, Erdener et al 36 have demonstrated that intraperitoneal PTX pretreatment in newborn rabbits did not have a protective effect on NEC.…”

Section: Discussionmentioning

confidence: 99%

“…19,21,26 The following laboratory investigations were done in all infants with suspicion of LOS: total and differential leukocyte count and assessment of serum C-reactive protein (CRP). 19,21,26 The following laboratory investigations were done in all infants with suspicion of LOS: total and differential leukocyte count and assessment of serum C-reactive protein (CRP).…”

Section: Methodsmentioning

confidence: 99%

“…[13][14][15][16][17] PTX has attracted attention of scientists since the discovery of its role in inhibition of TNF-α gene transcription and reduction of mortality from sepsis. Earlier observational, quasi-randomized and randomized trials 14,[19][20][21][22][23][24] revealed contradictory results. Earlier observational, quasi-randomized and randomized trials 14,[19][20][21][22][23][24] revealed contradictory results.…”

mentioning

confidence: 99%

“…18 Current evidence regarding the efficacy of PTX in NS as an adjuvant therapy to antibiotics is not clear. [19][20][21][22][23][24] Meta-analysis of the previous trials suggested that the use of PTX as an adjunct to antibiotics in NS decreases mortality without any adverse effects; however, it highlighted considerable methodologic limitations of these trials. [19][20][21][22][23][24] Meta-analysis of the previous trials suggested that the use of PTX as an adjunct to antibiotics in NS decreases mortality without any adverse effects; however, it highlighted considerable methodologic limitations of these trials.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Pentoxifylline Therapy for Late-Onset Sepsis in Preterm Infants

Shabaan¹,

Nasef²,

Shouman³

et al. 2015

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Background:The role of pentoxifylline (PTX) in reducing mortality associated with neonatal sepsis is not well established. We aimed to assess the efficacy and safety of PTX as an adjunct to antibiotics on mortality and morbidity in preterm infants with late-onset sepsis (LOS). Methods: Double blind, randomized controlled trial was conducted on 120 preterm infants with LOS. They were randomly assigned to receive either intravenous PTX 5 mg/kg/hr for 6 hours on 6 successive days or placebo. Death before hospital discharge was our primary outcome and secondary outcomes were length of hospital stay, duration of respiratory support, duration of antibiotics use, short-term morbidity of preterm infants, tumor necrosis factor-alpha concentrations, C-reactive protein concentrations, and adverse effects of PTX. Results: A total of 120 infants were enrolled, 60 in each group, 78 (65%) infants had confirmed and 42 (35%) had suspected LOS. There were no significant differences between groups regarding mortality [6 (10%) in PTX vs. 10 (16.5%) in placebo, P = 0.44], short-term morbidity and combined mortality and/or short-term morbidity [18 (30%) vs. 24 (40%), P = 0.23]. PTX therapy was associated with significant reduction of serum tumor necrosis factor-alpha and C-reactive protein concentrations. The length of hospital stay, durations of respiratory support and antibiotic therapy were significantly shorter in the PTX group. Patients in PTX group had less need for vasopressors, lower incidence of metabolic acidosis, disseminated intravascular coagulopathy and thrombocytopenia. No adverse effects to PTX were reported. Conclusions: PTX has a beneficial adjuvant effect to antibiotic therapy in preterm infants with LOS without significant impact on neonatal mortality and morbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Pentoxifylline Therapy for Late-Onset Sepsis in Preterm Infants

Shabaan¹,

Nasef²,

Shouman³

et al. 2015

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

show abstract

“…Granulocyte-CSF (G-CSF) and granulocyte-macrophage CSF (GM-CSF) cannot be recommended in neonatal sepsis. (b) IgGs are effective in adults with sepsis [45] but not in low-birth weight newborns (<1,500 g) [46] or in newborns with gestational ages of 31 to 42 weeks [47]. (c) A meta-analysis on the efficacy of immuno-modulating diets reported that they had no effect on mortality or length of stay of critically ill patients [48].…”

Section: Managementmentioning

confidence: 99%

Management of neonatal sepsis in term newborns

Pont‐Thibodeau¹,

Joyal²,

Lacroix³

2014

F1000Prime Rep

View full text Add to dashboard Cite

Neonatal sepsis is a common and deadly disease. It is broadly defined as a systemic inflammatory response, occurring in the first four weeks of life, as a result of a suspected or proven infection. Yet, more reliable and consistently applied diagnostic criteria would help improve our knowledge of the disease epidemiology. Several therapeutic attempts to control systemic inflammation in sepsis were unsuccessful. Immediate empirical administration of broad-spectrum anti-microbials, aggressive fluid resuscitation, and vaso-active or inotropic support (or both) are the mainstays of the therapeutic management of neonatal sepsis.

show abstract